Choice on dying currently extends only one way. How cruel is that?

David Seymour, sponsor of the End of Life Choice Bill, is looking to will propose changes at a future stage of the debate that will limit the any legislation's scope.

OPINION: Alex Penk, chief executive of the Maxim Institute, has concerns about the End of Life Choice Bill currently awaiting a second reading in Parliament. There's nothing wrong with that, as the issue is one that reasonable people can disagree on.

However, I think some of his concerns are misplaced, and others are missing some important context.

First of all, Penk worries about the parliamentary process being used to pass this proposed law. Its sponsor, David Seymour, will propose changes at a future stage of the debate that will limit its scope. That fact means that the bill's final shape is still somewhat uncertain.

However, what he doesn't note is that this process is required because those MPs on the justice select committee opposed to the bill blocked Seymour's changes from being incorporated into it at that earlier stage. No doubt they worried that other MPs would be more likely to support this limited bill than the original version.

It's then a little rich for the bill's opponents to complain that it is being enacted via a flawed process. And in any case, it seems almost certain that any final bill will require a referendum vote to become law, giving the ultimate say on its merits to the voters themselves.

Penk then raises the spectre that any legislation may be misapplied, leading to "deaths that would fall outside the bill's own criteria". This could occur, he worries, because of the difficulties involved in determining whether someone at the end of life really is competent to consent to a doctor's actions.

Of course, the End of Life Choice Bill requires that anyone requesting aid in dying be fully and directly informed of that decision's consequences. Their doctor also must use best efforts to ensure the request is free from pressure from any other person.

Two doctors would then independently assess the competency of that person to request aid in dying. If either doctor disagrees about this, a third specialist would be brought in to examine the case.

Compare this process to a lucid person with late-stage cancer who says that they want to end treatment and "let nature take its course". Although that decision will result in the patient's death, their doctor simply has to accept it as a competently made choice without any prescribed process being followed.

As such, we see shifting concerns about "competence", depending on what people are choosing to do. My suspicion is that these concerns don't really reflect an underlying judgment about whether people at their end of life are able to properly consent to treatment; after all, they already do so on multiple occasions every day.

Rather, it comes from a fear that people will choose something those opposed to aid in dying just don't like.

Penk then points to the slippery slope that opponents of aid in dying reliably claim will follow any legislation. In his case, it is to warn that other countries have extended access to people under 18 (which the End of Life Choice Bill would not allow).

It's an interesting argument that we can't possibly change the law today because we cannot trust some future majority of MPs, elected by a future majority of voters, not to change it further.

Laws in New Zealand do not alter by magic; they require Parliament to decide to act.

So, if and when there was some future proposal to widen the range of people who may access aid in dying, that would involve a new bill and full public debate on its merits. If we then collectively think the further change is a good idea, we can do it. If not, then we don't have to.

So, rather than worry about what our future selves may decide to do at some point years from now, we should ask ourselves whether the proposal in front of us today is a good one.

For as Penk notes, allowing aid in dying will mean people approaching the inevitable end of their lives can ask themselves: is my life still worth living? For some people, with their death approaching and experiencing unbearable suffering, the quite understandable answer will be no.

Are we as a society then going to be so cruel as to tell them, in effect, "tough luck"?